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Rhinoplasty for Medical Reasons Vs. for Cosmetic Reasons

I'm having surgery for medical reasons as I broke my nose in a fight and it affects my breathing, and was wondering if the surgeon would do anything different because it is for medical reasons not cosmetic? Lots of answers on here are for altering noses for beauty, but only a few for medical reasons (that I've found) Is there a difference? Besides what actually happens in the nose.

Doctor Answers 14

Medical rhinoplasty

What you are referring to are two non-cosmetic procedures: reconstructive rhinoplasty and septoplasty/sub mucous resection. The second procedure addresses a deviated septum or other obstructive condition inside the nose. The former would involve delayed treatment of a nasal fracture or other trauma. The motivations for these operations differ from the cosmetic rhinoplasty as do the end goals, which are functional over cosmetic. Insurance companies have strict standards now for reconstructive nasal surgery, often requiring that it occur within a designated time after the trauma, that the patient establish proof that conservative methods such as allergy treatments have failed to improve the breathing, and that the injury be corroborated by MRI or CT scan. Ironically, they spend more on the scans than what they pay participating surgeons but the goal is to limit surgeries and to deter cosmetic cases from being submitted for coverage.

New York Plastic Surgeon
5.0 out of 5 stars 14 reviews

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Trauma vs cosmetic

The surgical repair for nasal airway obstruction is most often only septal work that is not seen on the outside of the nose.  Unless the whole nose shifts to one side then it should appear more mid line.  What will be most noticeable is an improvement in your ability to breathe.

Rodger Wade Pielet, MD (in memoriam)
Chicago Plastic Surgeon
5.0 out of 5 stars 2 reviews

Functional rhinoplasty

Anytime rhinoplasty for cosmetic purposes is performed, the functional components of the nose should be improved or at least respected and preserved.  Improving nasal function after nasal trauma is paramount and should go hand in hand with improving cosmesis.  Seek an experienced rhinoplasty surgeon for both aspects.  

Etai Funk, MD
Houston Facial Plastic Surgeon
5.0 out of 5 stars 17 reviews


Ideally a board certified plastic surgeon (who performs cosmetic surgery) would reset your nasal bones (if they are displaced), while a board certified Ear Nose and Throat surgeon (who can work on your nasal passage) would help your cosmetic surgeon by making you breath better. Plastic surgeons are more inclined towards making noses beautiful at the expense of some functional compromise, while ENT surgeons are more functional in their approach. There are plastic surgeons who are good septoplasty surgeons, and many ENT surgeons are good rhinoplasty surgeons, but that's the exception not the norm. Pick your Dr.s carefully, and let your main concern (not coverage issues) guild you as to who to go to. Shop around for the right skill sets.

Ayman Hakki, MD
Washington DC Plastic Surgeon
4.5 out of 5 stars 15 reviews

Functional vs. Aesthetic Rhinoplasty

This is a fantastic question! Yes, there is a difference.  On one hand, functional rhinoplasty improves nasal breathing versus cosmetic which only addresses the aesthetic aspects.  You can have both address, one, or both depending on the areas which you feel need to be addressed.

Richard Ellenbogen, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 18 reviews

Rhinoplasty - medical vs cosmetic

Hi Cazz. There is a difference between functional and cosmetic nasal surgery (rhinoplasty), although similar techniques are used for both. When nasal surgery is performed for breathing difficulty or deformity, it is referred to as functional or reconstructive surgery. In the US, health insurance usually covers functional surgery for breathing issues, and may cover reconstructive surgery if the cause is medical or the injury is recent. Surgical maneuvers to fine-tune the nasal appearance in ways that do not improve function are considered cosmetic. Frequently, patients who will be undergoing functional / reconstructive rhinoplasty wish to utilize that opportunity to have cosmetic work performed - since they will already be under anesthesia and the surgeon will be already working on the nose. Functional / reconstructive nasal surgery can be combined with cosmetic nasal surgery if there is some purely cosmetic issue that you would like to have addressed at the time of surgery. I hope that helps your understanding. Good luck.

James M. Pearson, MD
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 40 reviews

Rhinoplasty fo Functional and Cosmetic Indications

I'm sure your surgeon will make cosmetic and functional changes to meet your individual needs and improve your nose during your rhinoplasty surgery.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 18 reviews

Rhinoplasty to correct breathing after nasal fracture

The overall approach to the nose in either a functional or cosmetic case is similar. If you only want the breathing to improve then straightening out the deviation of the nose and septum should help. Depending on your anatomy structural gratts (spreader graft, alar batten graft) may also help with both of these issues.

Thomas A. Lamperti, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 15 reviews

Surgery for breathing

If your only concern is breathing and you are happy with the way your nose looks then you don't need a rhinoplasty and it is considered a functional (or medical) vs. a cosmetic procedure.

Sam Naficy, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 154 reviews

Medical Rhinoplasty vs Cosmetic Rhinoplasty

 You plastic and cosmetic surgeon will need you to tell him/her that you want to cosmetically improve the look of your nose during the Rhinoplasty or this would not be addressed.  Fixing the breathing is completely separate and different than making the nose more attractive.  If you don't speak up, it won't automatically be done.  All aspects, goals, plans, risks, benefits of every surgical procedure should be discussed with the patient by the surgeon.  If it's not discussed and you are not consented for each procedure, it can't and shouldn't be done.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.5 out of 5 stars 12 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.